Connecticut 2021 Regular Session

Connecticut Senate Bill SB00202 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1
2	2
3	3	LCO No. 671 1 of 2
4	4
5	5	General Assembly Proposed Bill No. 202
6	6	January Session, 2021
7	7	LCO No. 671
8	8
9	9
10	10	Referred to Committee on INSURANCE AND REAL ESTATE
11	11
12	12
13	13	Introduced by:
14	14	SEN. LOONEY, 11th Dist.
15	15
16	16
17	17
18	18	AN ACT CONCERNING STEP THERAPY, ADVERSE DETERMINATION
19	19	AND UTILIZATION REVIEWS, AND REQUIRED HEALTH INSURANCE
20	20	COVERAGE FOR CHILDREN, STEPCHILDREN AND OTHER
21	21	DEPENDENT CHILDREN.
22	22	Be it enacted by the Senate and House of Representatives in General
23	23	Assembly convened:
24	24
25	25	That title 38a of the general statutes be amended to: (1) Prohibit health 1
26	26	carriers from requiring the use of step therapy for drugs prescribed to 2
27	27	treat disabling, chronic or life-threatening diseases or conditions; (2) 3
28	28	require that health carriers bear the burden of proving that certain 4
29	29	health care services under adverse determination or utilization review 5
30	30	are not medically necessary; (3) redefine "clinical peer" for the purposes 6
31	31	of adverse determination and utilization reviews; (4) require health 7
32	32	carriers to provide certain clinical peers with the authority to reverse 8
33	33	initial adverse determinations; and (5) allow children, stepchildren and 9
34	34	other dependent children to retain health insurance coverage under 10
35	35	their parents' insurance policies until the end of the policy year during 11
36	36	which they attain the age of twenty-six. 12 Proposed Bill No. 202
37	37
38	38
39	39	LCO No. 671 2 of 2
40	40
41	41	Statement of Purpose:
42	42	To: (1) Prohibit health carriers from requiring the use of step therapy for
43	43	drugs prescribed to treat disabling, chronic or life-threatening diseases
44	44	or conditions; (2) require that health carriers bear the burden of proving
45	45	that certain health care services under adverse determination or
46	46	utilization review are not medically necessary; (3) redefine "clinical
47	47	peer" for the purposes of adverse determination and utilization reviews;
48	48	(4) require health carriers to provide certain clinical peers with the
49	49	authority to reverse initial adverse determinations; and (5) allow
50	50	children, stepchildren and other dependent children to retain health
51	51	insurance coverage under their parents' insurance policies until the end
52	52	of the policy year during which they attain the age of twenty-six.